Five-Year Follow-up of Correction of Myopia: Posterior Chamber Phakic Intraocular Lens With a Central Port Design

Abstract

PURPOSE: To assess the long-term correction of moderate to high myopia using a posterior chamber phakic intraocular lens with a central port design. METHODS: Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events over a 5-year period were evaluated retrospectively. RESULTS: A total of 147 eyes (83 patients) were evaluated. Mean postoperative UDVA and CDVA were 0.05 ± 0.11 and 0.02 ± 0.08 logMAR at 1 year and 0.13 ± 0.18 and 0.02 ± 0.09 logMAR at 5 years, respectively. More than 95% of eyes achieved CDVA of 20/25 or better at both follow-up periods. CDVA was unchanged or improved from one to three or more lines in all eyes. Preoperatively, mean spherical equivalent (SE) was −9.20 ± 3.02 diopters (D). At 1 year, the mean SE was −0.17 ± 0.26 D, with 91.53% of eyes within ±0.50 D and 100% of eyes within ±1.00 D of the target. At 5 years, the mean SE was −0.44 ± 0.47 D, with 67.4% of eyes within ±0.50 D and 90.1% of eyes within ±1.00 D of the target. Mean IOP was 12.74 ± 1.65 and 13.0 ± 2.03 mm Hg, at 1 and 5 years, respectively. No significant rise in IOP (> 20 mm Hg) occurred during the follow-up period. Mean ECD was 2,696 ± 358 and 2,645 ± 359 cells/mm 2 at 1 and 5 years, respectively, representing a non-significant loss of 0.43% from preoperative values ( P = .304). Mean vault changed significantly from 398 ± 187 µm at 1 year to 340 ± 163 µm at 5 years ( P < .001). No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS: The good long-term outcomes found in this study support the use of this lens with a central port design for the correction of moderate to high myopia. [ J Refract Surg . 2019;35(3):169–176.]

Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age

“…However, all these studies evaluated patients implanted with older ICL models. With the present V4c ICL, recent long-term studies [13,14] and meta-analysis reported no postoperative complications [1,2]. Kamiya et al [3] and Takahashi et al [4], in an older patient sample (with 6 months of follow-up) similar to ours, did not report either asymptomatic or symptomatic cataract formation.…”

“…However, our follow-up of 1 year is short and these patients should be kept under follow-up for longer periods. Shimizu et al [13] and Alfonso et al [14] with 5 years of follow-up in younger patients implanted with this lens followed this approach of extended follow-up period (mean ages of 31.9 and 31.2 years, respectively). Our mean ECD at 1 year showed no statistically significant differences with their corresponding preoperative values (2516 ± 234 vs. 2568 ± 332 cells/mm 2 , p � 0.29).…”

“…The change in vault with time has been also reported in a long follow-up study with this specific model. The 5-year study carried out by Alfonso et al [ 14 ] showed a reduction of about 1.2 μ m/month. Changes with time (due to crystalline lens thickening) should be always borne in mind, especially in patients with low vault values.…”

​Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation

“…The Implantable Collamer Lens (ICL; STAAR Surgical Co, Monrovia, California) is a safe and effective option for the correction of myopia [1][2][3][4]. With no corneal excision and few high-order aberrations, it is often the rst choice for surgical correction of high myopia [5,6].…”

Correlation between vaulting intraoperative and postoperative of EVO implantable Collamer lens: a retrospective study of real-time observations of vaulting using the RESCAN 700 system

“…Previous methods for determining vaulting involved white-to-white measurement (manually or with imaging systems) or sulcus-to-sulcus measurement using high-frequency ultrasound have been the main methods for vaulting prediction [17,18]. Later, optical coherence tomography (OCT) was added to re ne the prediction [19][20][21]. Recent OCT systems that are built within the operating microscope now allow for more precise eye surgeries [22][23][24].…”